Subscribe
106
Jiang Guo Ming
Gastroenterology
About me
In 1994, graduated from Nanjing University of Chinese Medicine and started working at Yanshan Branch of Liyang People's Hospital and Liyang Maternal and Child Health Hospital in the same year. From May 1999 to August 2000, underwent further training in the Gastroenterology Department of the First People's Hospital of Changzhou. Currently serving as the Director of the Emergency Department at the hospital, with the title of Associate Chief Physician.
Proficient in diseases
Mainly engaged in the treatment of gastroenterology with a combination of traditional Chinese and Western medicine, as well as the operation of digestive endoscopy.
Voices
Treatment of gastric ulcer with bleeding
For the treatment of gastric ulcers with bleeding, it is primarily necessary to determine the treatment plan based on the amount of bleeding. If the bleeding is minor, it can be treated with oral medication, and whether there is an infection with Helicobacter pylori must be considered. If there is an infection of Helicobacter pylori, the typical treatment is a quadruple therapy, which includes a proton pump inhibitor, two antibiotics, and a bismuth agent. If there is no Helicobacter pylori infection, symptomatic treatment is sufficient, commonly using proton pump inhibitors. If the bleeding is severe, timely hospitalization is needed. The treatment usually involves the intravenous use of proton pump inhibitors primarily, and if the medication is ineffective, endoscopic treatment might be necessary. This could include the application of hemostatic medications, electrocoagulation, or the use of titanium clips, etc. (Please use medication under the guidance of a doctor.)
Why does a peptic ulcer bleed?
Peptic ulcers include gastric ulcers, duodenal bulb ulcers, and so on. Gastrointestinal bleeding is one of the common complications of peptic ulcers, usually caused by the ulcer being relatively large or deep, invading the blood vessels, leading to vessel rupture and resulting in bleeding. For minor bleeding, the patient may not have any discomfort symptoms, primarily indicated by black stools or a positive fecal occult blood test. If there is substantial bleeding, it can lead to symptoms such as vomiting blood. Such cases need attention and usually require hospitalization for observation and treatment. Sometimes, recurrent gastrointestinal bleeding may require surgical treatment.
Symptoms of acute gastritis attack
Acute gastritis is also a common and frequently occurring disease in gastroenterology, with a relatively sudden onset and more severe symptoms compared to other types of gastritis. The majority of causes are due to inappropriate diet, such as excessive consumption of cold, spicy food, or alcoholic beverages. Certain medications can also lead to this condition, such as non-steroidal anti-inflammatory drugs and corticosteroids. Symptoms often manifest as episodic upper abdominal bloating or colic, accompanied by acid reflux, heartburn, abdominal distension, etc. If acute gastric mucosal lesions occur, there are often signs of bleeding, such as black stools or even vomiting blood.
Is bleeding from a gastric ulcer serious?
Upper gastrointestinal bleeding is one of the common complications of peptic ulcers. If gastric ulcers cause vomiting blood, it often indicates that the bleeding is not minor and the condition is generally severe. It is usually considered that when about 250-300mL of blood accumulates in the stomach, vomiting blood may occur. Clinically, if vomiting blood occurs, it is firstly necessary to promptly hospitalize for treatment, including establishing venous access, nutritional support, and hemostatic treatment. Proton pump inhibitors or somatostatin analogs are commonly used. Additionally, if the bleeding does not stop, endoscopic treatment can be performed, such as spraying hemostatic drugs, electrocoagulation, or mechanical hemostasis. It is also necessary to monitor the patient's vital signs. If repeated bleeding occurs, a comprehensive treatment plan may be needed.
How long does acute gastritis require hospitalization?
Acute gastritis usually has a sudden onset and relatively severe symptoms. It can include upper abdominal pain, acid reflux, heartburn, nausea, vomiting, and even an inability to eat. This condition is most often caused by poor diet, such as excessive drinking, spicy and irritating foods, etc., and can also be induced by medication, such as non-steroidal drugs or hormonal drugs. The duration of hospital treatment depends on the specific situation. If the patient's general condition is acceptable and they can eat, recovery typically takes about three to five days. Therefore, the duration is not usually very long. However, in some cases, such as drug-induced acute gastric mucosal lesions, which are relatively severe and can involve bleeding, treatment with medications usually requires at least a week or more.
What should I do if there is bleeding from a gastric ulcer?
If there is only a small amount of bleeding in gastric ulcer bleeding, manifested as black stool without any other special discomfort symptoms, this condition can be treated with oral medication in an outpatient setting. The treatment plan is usually determined based on the presence or absence of Helicobacter pylori infection. For those with Helicobacter pylori infection, a quadruple therapy is generally used for eradication treatment. For those without the infection, proton pump inhibitors are the preferred choice, combined with medications that protect the gastric mucosa, and so on. If there is a significant amount of bleeding, with symptoms like vomiting blood, this situation requires timely hospital treatment, usually involving fasting and intravenous fluid therapy. If medical treatment is ineffective, a combined medical and surgical approach may be necessary. (The use of medications should be under the guidance of a doctor.)
How to treat chronic gastritis?
For the treatment of chronic gastritis, it is generally considered necessary to decide the treatment plan based on whether there is a Helicobacter pylori infection. This can be determined through a C13 or C14 breath test. If the test is positive for H. pylori, it indicates a bacterial infection. The typical treatment in this case would involve a quadruple therapy that includes a proton pump inhibitor, two types of antibiotics, and a bismuth agent. If there is no H. pylori infection, symptomatic treatment is generally sufficient, such as inhibiting stomach acid, protecting the stomach lining, increasing gastric motility, etc. Additionally, it is necessary to develop good dietary and living habits. Furthermore, emotional factors are closely related to the activity of chronic gastritis, so maintaining a positive mental attitude is beneficial for digestive system diseases.
What causes gastritis?
Chronic gastritis can be divided into two main categories: chronic non-atrophic gastritis, which was previously referred to as chronic superficial gastritis, and chronic atrophic gastritis. The primary cause of chronic gastritis is generally considered to be Helicobacter pylori infection, which has a very high infection rate in our country, exceeding 50%. Moreover, inappropriate diet can also cause chronic gastritis, such as stimulation from smoking and drinking, irregular eating habits, overeating, as well as excessive consumption of raw, greasy, spicy, and other irritating foods. Additionally, emotional factors are closely related to chronic gastritis.
Symptoms of gastroenteritis
Gastrointestinal flu is caused by a viral infection, commonly seen in the summer and fall seasons, and its symptoms often include those of both upper respiratory tract infections and acute gastroenteritis. Symptoms of upper respiratory infection include fever, chills, dizziness, headache, fatigue, general muscle pain, sore throat, cough, etc.; symptoms of acute gastroenteritis are vomiting, diarrhea, abdominal bloating, abdominal pain, etc., often presenting as watery stools. This disease can be diagnosed through routine blood tests and stool exams, which help distinguish it from bacterial infections causing diarrhea. Treatment typically involves oral antiviral medications and anti-diarrheal drugs.
Asymptomatic peptic ulcer
Peptic ulcers typically include duodenal bulb ulcers and gastric ulcers. They more or less have typical related symptoms, such as long-term, recurrent, regular upper abdominal pain related to eating, along with symptoms like acid reflux. Diagnosis can be confirmed through gastroscopy. A small portion of patients, especially middle-aged and elderly patients with a history of cardiovascular and cerebrovascular diseases, often take non-steroidal anti-inflammatory drugs (NSAIDs) year-round. This situation can easily lead to the occurrence of acute gastric mucosal lesions and often results in asymptomatic gastric ulcers. Many patients present with symptoms like vomiting blood and black stools when they seek medical advice.